Kornimate/medical-research-clean huggingface dataset:
evaluation of quality of care - multi-disciplinary risk assessment and management programme for patients with hypertension, ha (qoc ramp-ht)

Conditions: Hypertension

Summary: hypertension (ht) is one of the major cause of morbidity and among the top 10 causes of deaths in hong kong in 2008 (department of health 2009). the hospital authority (ha) has initiated service improvement through introducing the risk assessment and management programme (ramp) to improve the quality of care (qoc) for ht patients in general outpatient clinics (gopc). the evaluation on the qoc is an essential part of the programme in order to inform future policy. the department of family medicine and primary care (fmpc) of the university of hong kong (hku) has been appointed by the ha to carry out the evaluation of the qoc of the programme. the action learning and audit spiral methodologies to measure whether the target standard of care intended by the ramp programme is achieved. each ramp participating clinic and hospital will be invited to complete a structured evaluation questionnaire. the data of all patients who have enrolled into the ramp for more than one year will be included in the evaluation on the process and outcomes of care. one thousand two hundred and forty-eight age and disease matched control patients who have not been enrolled into the ramp programme will be selected for the comparison in the outcomes of care. a hundred and thirty participants will be followed up by telephone to evaluate the effect of the programme in quality of life (qol), patient enablement, and global rating of change in health condition at baseline and 6 months after enrolment. data on the process of care will be retrieved from the ha medical records. main outcome measures: the primary outcomes are the proportion of participants who have received the criterion process of care, and achieved the target blood pressure levels. data analysis: descriptive statistics on proportions of centers or subjects meeting the qoc criteria will be calculated. the changes in the clinical and patient reported outcomes of ramp subjects will be compared at 12, 24, 36 and 48 months will be compared by paired sample t-test. the clinical outcomes between ramp subjects and control group will be compared by independent sample t-test or chi-square test. results: the qoc of the ramp programme will be determined. areas of deficiency and possible areas for quality enhancement will be identified. conclusion: the results of this study will provide empirical evidence on whether the ha's ramp programme can achieve improvement in qoc for ht patients. the information will be used to guide service planning and policy decision making.


Eligibility criteria:
inclusion criteria: * ht * aged \<80 * suboptimal bp control (average systolic blood pressure (sbp) ≥ 140mmhg or average diastolic blood pressure (dbp) ≥ 90mmhg) exclusion criteria: * patients will be excluded if they are unable to understand or communicate in chinese language, or refuse to give consent. * patients will be excluded if they had prior history of diabetes and existing cardiovascular diseases

Keywords: hypertension
somatropin treatment in patients with shox deficiency and turner syndrome

Conditions: Failure to Thrive

Summary: this clinical trial will compare the mean first year height velocity of somatropin-treated prepubertal patients with shox deficiency with the height velocity of a control group of untreated prepubertal patients with shox deficiency. both groups will be compared to a somatropin-treated group of girls with turner syndrome. after the second year patients in the control group have the option to receive treatment as well. all patients will optionally be treated until they achieved adult height.


Eligibility criteria:
inclusion criteria: * turner syndrome or shox disorder * shox: bone age greater than 10 years for boys, greater than 8 years for girls, turner: bone age greater than 9 years * height below 3rd percentile or height below 10th percentile and growth velocity below 25th percentile * prepubertal: for girls, tanner stage 1, for boys tanner stage 1 and testicular volume no more than 2 ml exclusion criteria: * gh deficiency or known insensitivity * evidence of tumor activity * diabetes mellitus or history of impaired glucose tolerance * any severe illness known to interfere growth
high intensity training for patients with anxiety

Conditions: Anxiety; Depression Anxiety Disorder; Blood Pressure Check (Hypertension Screening)

Summary: the aim of the current project is to examine the effects of high intensity exercise (by using 1x4 intervals) to reduce symptoms of anxiety in patients in mental health care. the expected benefits for patients are positive health effects, by improving physical fitness and reducing psychological symptom burden. the patients will have the opportunity to learn to use physical activity as a specific measure to be used in their own lives and be a source of coping. furthermore, knowledge about physical activity and mental health may be applicable in mental health care as a part of a treatment plan.

the study is a randomised controlled trial ("rct") design with a 1:1 allocation into two groups. the two groups are high intensity exercise (1x4 minutes performed two times per week with a heart rate above 85% of maximal heart rate) and low intensity exercise (45 minutes performed two times per week with a heart rate of approximately 60% of maximal heart rate). the total amount of training sessions for both groups will be eight. the high intensity exercise group will serve as the intervention group, while the low intensity exercise group will serve as an active control group. the patients will be randomly allocated (randomised) to these groups. an exercise physiologist (holding a master's degree in exercise physiology) will supervise the training sessions. the training sessions will take place in a dedicated room using a treadmill and a heart rate monitor. the training sessions will be individual. the primary outcome measure will be degree of anxiety symptoms measured by hospital anxiety and depression scale (hads) and beck naxiety inventory (bai) prior to the first (pre) and after the last (post) training session is completed. secondary outcome measures will be compliance, i.e. to what degree the patient is able to sustain the exercise regimen three months after participating in the project, in addition to the patient's blood pressure.

Eligibility criteria:
inclusion criteria: * patients with mild/moderate anxiety disorders, aged 18-60 years. anxiety disorders in accordance with f 41 in icd-10, including generalised anxiety disorder, agoraphobia/panic disorder, social phobia, post-traumatic stress disorder, hypochondria, and obsessive-compulsive disorder. * comorbidity will occur, so the patient may also have depression. however, the main disorder should be anxiety. exclusion criteria: * somatic diseases that may impede training: cardiovascular disease, severe asthma, severe copd, cancer, poorly regulated diabetes. * schizophrenia or bipolar disease * suicidality (prior attempts or ongoing risk of suicide) * substance addiction

Keywords: physical exercise mental health high intensity training
quantra qstat in trauma and liver transplant

Conditions: Hemorrhage; Trauma; Liver Transplant

Summary: this is a multi-center prospective, observational study of the quantra system with the qstat cartridge in trauma patients and patients undergoing liver transplant.

the quantra system is a fully integrated and automated in vitro diagnostic device which uses seer sonorheometry, an ultrasound-based technology, to characterize the viscoelastic properties of a whole blood sample during coagulation. the qstat cartridge was developed to monitor hemostasis in patients that may experience a range of coagulopathies of various etiologies, including fibrinolytic defects. these patients include the trauma and liver transplant populations. the cartridge consists of four independent channels each containing different sets of reagents, which provide four measurements performed in parallel yielding five parameters that depict the functional status of a patient's coagulation system. this multi-center, prospective, observational pilot study will evaluate the performance of the quantra system with the qstat cartridge as compared to conventional viscoelastic testing methods in blood samples obtained from trauma patients and patients undergoing liver transplant.

Eligibility criteria:
inclusion criteria: * subject is \> 18 years * subject is a trauma patient experiencing traumatic injuries requiring a full trauma team response or subject is a patient undergoing liver transplant surgery. * subject, or subject's legally authorized representative (lar), is willing to provide informed consent, either prospectively or by deferred consent, or institutional review board (irb)/ethics committee (ec) has waived the requirement to obtain informed consent. exclusion criteria: * subject is younger than 18 years of age * subject is pregnant. * subject is incarcerated at the time of the study. * subject is currently enrolled in a distinct study that might confound the result of the proposed study * subject is affected by a condition that, in the opinion of the surgical team, may pose additional risks.

Keywords: viscoelastic testing coagulation trauma liver transplant quantra qstat
sevoflurane as an anesthetic during dilation and evacuation procedures

Conditions: Blood Loss; Anesthesia

Summary: sevoflurane is an fda-approved anesthetic drug commonly used for anesthesia during second trimester abortion procedures. it has a few advantages, including ease of use by the anesthesia provider. however, the literature suggests that when used in doses higher than those used at oregon health \& science university (ohsu) and lovejoy, it is associated with an increase in the risk of bleeding. the investigators study aims to test whether the lower dose used at ohsu and lovejoy during second trimester abortion procedures causes any difference in blood loss, when compared to similar abortion procedures for which this drug is not used.

this study seeks to examine the bleeding complications associated with use of sevoflurane in general anesthesia regimens for second trimester abortion procedures and assess anesthesia providers' use and beliefs regarding possible risks associated with newer inhalational agents such as sevoflurane in this setting. participants' anesthesia will either be intravenous (iv) propofol, iv midazolam, iv fentanyl and nitrous oxide or this same regimen combined with sevoflurane during maintenance of anesthesia. procedural outcomes, specifically those related to bleeding complications, including need to intervene for excess blood loss, will be recorded and analyzed to establish if such a relationship between use of sevoflurane and excess blood loss exists.

Eligibility criteria:
inclusion criteria: * voluntarily requesting pregnancy termination * estimated gestational age of 18 weeks - 23 weeks, 6 days gestational age as calculated by fetal biparietal diameter on clinic ultrasound. * be able and willing to sign an informed consent and agree to terms of the study exclusion criteria: * known severe maternal respiratory disease or upper respiratory infection or sinus blockage * anticoagulation use: within 24 hours if lovenox, or within 12 hours if heparin, (must have a documented normal international normalized ratio (inr) prior to procedure if on anticoagulation) * multiple pregnancy * fetal demise, if more than 2 weeks difference exists between known gestational age (by previous us dating) and gestational size on current ultrasound. * known allergy/sensitivity to sevoflurane or any other inhaled anesthetic agents

Keywords: sevoflurane anesthesia abortion blood loss
clinical study evaluating the efficacy and safety of cid v2.2 in glaucoma surgery

Conditions: Glaucoma, Open-Angle; Glaucoma, Narrow Angle

Summary: the purpose of this study is to evaluate the safety and effectiveness of implanting a new version of an interposition supraciliary implant (sv22) as a stand-alone therapy for lowering intraocular pressure (iop) in patients with primary open and narrow angle glaucoma who have failed at least one class of topical medical therapy

35 patients will be included in this 36 months interventional study. all patients shall be indicated for glaucoma surgery alone (not combined with cataract), and will undergo incisional glaucoma therapy, including a simplified surgical technique allowing the placement of an interposition supraciliary permanent device. several patient data like safety events, iop, visual capacity or associated pharmacological treatments will be recorded pre and post-operatively all along the follow-up. purpose is to ensure device safety, and verify iop and associated pharmacological treatment reduction after surgery, and evolution along follow-up.

Eligibility criteria:
inclusion criteria: * diagnosis of poag schafer 1 to 4 * medicated iop ≥ 21 * naive of any prior glaucoma surgery exclusion criteria: * inflammatory, congenital, traumatic, neovascular, ice syndrome, angle closure and schaffer 1 and 2 glaucoma
comorbid painful tmd among trigeminal neuralgia

Conditions: Trigeminal Neuralgia; Temporomandibular Disorder; Myofascial Pain; Trigeminal Neuropathy

Summary: an observational study following up with trigeminal neuralgia patients to understand their comorbid facial pain condition, specifically temporomandibular disorder.

this multi-center prospective observational cohort study aims to investigate the prevalence of comorbid temporomandibular disorders (tmd) among trigeminal neuralgia (tn) patients. trigeminal neuralgia patients with active tn status from three clinical sites (university of minnesota, school of dentistry, orofacial pain clinic; mhealth fairview, clinical surgical center, neurosurgery clinic; john hopkins university, anesthesiology, and critical care clinic) could enroll in this study voluntary. all the patients will be evaluated by a provider using standard clinical assessment for tn and tmd, along with validated redcap questionnaires for tn and tmd diagnosis, and be followed up every six months for 1-2 years.

Eligibility criteria:
inclusion criteria: * patients visited the three clinical sites for facial pain * patients diagnosed with trigeminal neuralgia * has active pain symptoms in the past 30 days exclusion criteria: * non-english speakers * patients with psychiatric disorders that might alter pain perception * adults lack the capacity to provide informed consent. * persons under the age of 18. * all vulnerable populations.
prevalence and consequences of urinary incontinence in people with chronic pulmonary diseases referred for pulmonary rehabilitation

Conditions: Chronic Pulmonary Disease; Pulmonary Rehabilitation; Urinary Incontinence

Summary: urinary incontinence is a frequent chronic condition in general population. it is even more frequent in people with chronic respiratory disease due to several factors, including but not limited to frequent cough. urinary incontinence may be more frequent during exercise so that it may contribute to the general deconditioning associated with chronic respiratory disease. although pulmonary rehabilitation is a cornerstone in the management of people with chronic respiratory disease to break this spiral of worsening dyspnea, little is known about the prevalence of urinary incontinence among those people referred for pulmonary rehabilitation nor about its impact on the effects of the program.

experimental design: people referred for pulmonary rehabilitation in two centres will be offer to participate in the study. those people who will agree to participate and give their formal consent will be asked to answer two questionnaires about urinary incontinence symptoms (see outcomes) to assess the prevalence and the type of these symptoms. they will subsequently participate in their usual pulmonary rehabilitation program consisting in 90min sessions (including endurance training, muscle strengthening and self-management), 3x/week for 8weeks (centre 1) or 2x60min sessions (including the same components), 3x/week for 8weeks (centre 2). the effects of the pulmonary rehabilitation program on usual clinical outcomes (according to each centre routine practice; tests may differ between centres) will be compared between those people with or without urinary incontinence symptoms. as no prevalence data about urinary incontience was available at the time of study design, we planned to recruit the first 100 participants within the first year and to update the sample size calculation based on these preliminary data. among the 70 people actually included, 21 (30%) experienced urinary incontinence. therefore, assuming a true prevalence of 30% in this population and a total width for the 95% confidence interval of 10%, we planned to recruit a total 341 participants. the ethical approval to recruit this updated number of participants and to increase the duration of recruitment accordingly was obtained.

Eligibility criteria:
inclusion criteria: * age \> 18 ans ; * referred for pulmonary rehabilitation ; non inclusion criteria: * history of pathology or prostate surgery ; * contra indication to pulmonary rehabilitation ; exclusion criteria: * pregnant woman or likely to be ; * patient under guardianship ; * patient withdrawal ; * did not complete at least 18 pulmonary rehabilitation sessions.
hepatitis b prevalence in the turkish population living in middle limburg

Conditions: Hepatitis B

Summary: this study will assess hbv (hbsag, anti-hbc and anti-hbs) prevalence in the turkish population living in belgium. additionally, the investigators will determine the risk factors for hbv infection and the uptake of screening, vaccination and antiviral treatment in this hard-to-reach turkish population.

hbv infection is an important public health problem in the turkish population, i.e. one of the largest migrant populations in europe. with the introduction of cost-effective antiviral treatments in the past decade, there is a need to identify hbv infected patients who may benefit from treatment. this study will assess the hbv prevalence in the turkish population living in belgium. additionally, the investigators will determine the risk factors of hbv infection and the uptake of screening, vaccination and antiviral treatment in this hard-to-reach turkish population. a cross-sectional, epidemiological trial will be conducted in the region middle limburg belgium, where the turkish adult population (subjects born in turkey or subjects of which one of the parents is born in turkey), 18 years of age and older, will be screened for hbsag, anti-hbs and anti-hbc. educational meetings concerning viral hepatitis b will be organized and there will be three ways to be screened for hbv: (1) immediately after the educational meetings, (2) at the outpatient hepatology department of ziekenhuis oost-limburg (zol) and (3) at home visits. subsequently, participants will be asked to fill in a questionnaire regarding sociodemographic factors, migration history, risk factors for hbv infection (e.g. sharing toothbrushes, hbv infected family member) and hbv vaccination status. one year after data collection, hbsag positive patients will be assessed whether they are under follow-up at the general practitioner or hepatologist. the investigators will also gather information regarding the uptake of vaccination in non-immunized subjects. this study will provide information about the hbv prevalence and distribution of the stages of liver disease in the turkish population in belgium. by determining the risk factors for hbv infection, subgroups with an increased prevalence of hbv infection can be identified. this study will also give information on how to organize the healthcare system for screening in hard-to-reach migrant groups and to develop care paths.

Eligibility criteria:
inclusion criteria: * turkish origin, defined as one of the parents born in turkey * having a signed informed consent form exclusion criteria: /

Keywords: hepatitis b disease prevalence screening migrant turkish belgium
virtual reality to improve low-back pain and pelvic pain during pregnancy

Conditions: Low Back Pain; Pelvic Pain

Summary: a large percentage of women suffer low back and pelvic pain both during and after pregnancy. there are several factors to which these complaints are attributed, even affecting their daily lives. it is identified that many of these women do not receive adequate health care, however, different physiotherapeutic interventions are recommended to alleviate these conditions, presenting moderate levels of evidence. virtual reality (vr) is presented as a complementary and promising treatment method to physiotherapy for the improvement of fundamental variables such as perceived pain and pain avoidance. the main objective is to evaluate the efficacy of a combined vr and physiotherapy program of 4 weeks duration compared to a standard physiotherapy intervention in pregnant women with low back pain and pelvic pain for the improvement of pain avoidance, pain intensity, disability and functional level. as a secondary objective the investigators propose to investigate patient satisfaction with the vr intervention. this research will be carried out by means of a multicenter randomized controlled clinical trial in pregnant patients residing in the provinces of seville and malaga with a diagnosis of low back pain and pelvic pain during pregnancy. the alternative hypothesis of this research is that the implementation of a virtual reality program together with standard physiotherapy in pregnant patients with low back and pelvic pain presents better clinical results obtained with the current standard intervention, which may represent an opportunity to define new policies and interventions for these pathologies and their consequences.


Eligibility criteria:
inclusion criteria: * adult woman over 18 years old * pregnant woman with low back pain, pelvic pain (pp) or both conditions with symptomatic character. * pregnant woman between the 12th and 36th week of gestation, corresponding to the 2nd and 3rd trimester. * pain intensity greater than 4/10 on vas, indicating moderate-severe pain. * live in sevilla or malaga during the research period. exclusion criteria: * patients with lbp or pp pain prior to pregnancy. * cognitive ability not suitable for the use of technological tools. * patients with absolute or relative contraindications.
effects of segmental stabilization on the anticipatory postural adjustment of subjects with lumbar pain

Conditions: Lumbar Pain

Summary: this study aims to verify the effects of a segmental stabilization exercise program on the anticipatory postural adjustment of subjects with chronic lumbar pain. the effects will be assessed by means of superficial electromyography focused on the registry of the onset of multifidius and deltoid (anterior and posterior) activity during a repetitive shoulder ﬂexion/extension.


Eligibility criteria:
inclusion criteria: * women aged between 18 and 65 years old * chronic lumbar pain (at least 3 months) * average pain intensity of ≥3 on a 10-point scale exclusion criteria: * presence of red flags (i.e.,tumor, known fractures, diagnosed inflammatory joint disease, etc); * history of back surgery * pregnancy * less than 3 months of therapeutic treatment (physiotherapy) for low back pain